Private philanthropic support for the AIDS epidemic decreased by 5 percent, or $37 million, in 2017 – the lowest level in three years, according to a new report.

The 16th annual “Philanthropic Support to Address HIV/AIDS” was released by the Funders Concerned About AIDS (FCAA) last week ahead of World AIDS Day on Dec. 1. The 44-page study indicates private philanthropic organizations accounted for $638 million from 427 funders in 2017. The 6,778 grants to 3,400 grantees was the lowest amount of disbursements since 2014. Last year’s decline follows three straight years of growth, reaching an all-time high of $680 million in 2016.

While support by the top two funders of HIV-related philanthropy increased by $33 million (Bill & Melinda Gates Foundation, $214 million, and Gilead Sciences, $155 million), and 13 of the top 20, the total amount of funding was offset by decreases among the other seven funders.

Only 2 percent of all global resources for HIV come from philanthropic support, with domestic governments accounting for 57 percent and bilateral funding from donor governments another 30 percent, according to the study. “Private HIV and AIDS philanthropy has helped drive incredible progress against the epidemic, despite seemingly insurmountable odds,” FCAA Executive Director John Barnes said via a press release announcing the study.

Some 9 percent of all grantmakers represented a corporation or corporate related giving program, their support represented 36 percent, or $242 million, of total HIV-related philanthropy in 2017. Only 6 percent of funders represent organizations that focus specifically on HIV yet those that do account for about a quarter of total funding, about $144 million.

Overall philanthropy from U.S.-based foundations and corporations in 2017 was $87.7 billion, up 13 percent from 2016. About 62 cents of every $100 awarded by U.S. foundations and corporations in 2017 goes to HIV/AIDS issues, according to the report.

Research ($210 million), prevention ($169 million) and treatment ($142 million) were the leading uses of philanthropic funding for HIV/AIDS last year.

Not every aspect of the report showed a decline. Funding for general operating/administration grants increased by almost $30 million. Significant increases were recorded for funding related to transgender populations (110 percent), gay men/men who have sex with men (35 percent), and economically disadvantaged or homeless populations (31 percent).

Other findings in the report included:

Sex workers experienced a 24 percent decrease in private support from 2016, despite the fact that they are 13 times more at risk for contracting HIV than the general population;

Middle income countries saw a 21 percent decrease, even though they are home to more than half of all people who live with HIV/AIDS; and,

The FCAA was founded in 1987. Considered to be the leading voice on philanthropic resources for the global AIDS epidemic, the organization has supported philanthropic leadership and funders in their mission to eradicate the HIV/AIDS pandemic.